Complications of laparoscopic and laparotomic treatment of endometrial cancer

OBJECTIVE: The aim of the study is to compare advantages, disadvantages and complications of the laparoscopic and clasical laparotomic operations in the patients treated for endometrial carcinoma at our Department and to find out the optimal strategy. DESIGN: Retrospective study. SETTINGS: Department of Gynaecology and Obstetrics, Medical Faculty, Palacky University and University Hospital, Olomouc. MATERIAL AND METHODS: A total of 165 endometrial cancer patients were operated on since 2004 till 2008 at our department. The clasical laparotomic approach was used in 141 patients and 24 were operated laparoscopically. Both groups were comparable in clinical staging and other parameters. The clinical parameters compared were the frequency of inflammatory complications, urinary passage injury, blood loss, transfusions, operating time and hospital stay. RESULTS: The average operating time for laparotomic operations was 137 minutes and for the laparoscopic ones 175 minutes. The mean hospital stay after clasical operation was 7.8 days, and 6.7 days after laparoscopy. The estimated blood after clasical operation was 410 ml and 8.5% of patients received blood transfusion. Blood loss after laparoscopy was only 214 ml but 12.5% of patients necessitated blood transfusion. Complications due to infection were more often in patients with laparotomy (5.7%) while they occurred only in 4.1% after laparoscopies. The injury of the urinary tract was recorded only in 1 patient (0.7%) in the laparotomy group while it was more frequent in the laparoscopic group (2 patients i.e. 8.3%). CONCLUSIONS: The main advantage of laparoscopy at the operations of the endometrial cancer is the shorter hospital stay resulting in lower costs, less postoperative discomfort and a minimum of inflammatory complications. On the other hand there were more frequent urinary tract injuries and the operating time was usually longer at laparoscopies compared to laparotomies. Nevertheless, it seems that the use of the laparoscopic operations for endometrial cancer will probably be increasing.